CP
Cailyn P

1 reviews | Active since Oct 2022

08 Feb 2024, 13:24

One Giant Fight Every Claim

You get a sum of R1500. 00 to claim from Radiology annually. This includes ultrasounds, CT and MRI scans, mammograms etc.... However when you are pregnant they do not allow you claim from the different sections of the insurance. You cannot claim from Radiology if you go for an ultrasound (even though you still have the full R1500 available), you cannot claim from GP visits if it's regarding your pregnancy, you cannot claim from your annual Pathology section if you are pregnant. NOWHERE on the policy does it say you are not allowed to claim from these sections when pregnant but when you claim, the claims department rejects the claim because it is related to pregnancy! You are only allowed 3 pre-birth claims (R600 each).

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Replies (1)
Oneplan Insurance
Oneplan Insurance's reply08 Feb 2024, 15:21
Official
Dear Cailyn,

Thank you for taking the time to bring this to our attention. 

We apologize that your experience with Oneplan has not been a pleasant one and apologize for the inconvenience that has been caused. We do take customer feedback seriously to improve our service and processes to ensure that we meet our client’s expectations. 

Please note that our Health Insurance plans have different cover limits for various benefits, and these specified limits and features apply.

We have acknowledged your complaint and escalated it to the relevant department. One of our Claims managers will contact you to discuss the matter further. 
                 
Once again, we apologize for any inconvenience caused and we hope to restore the experience.         
Kind Regards,
Oneplan